Inspection on 21/01/09 for 11 Heathervale Close

This inspection was carried out on 21st January 2009.

CSCI found this care home to be providing an Good service.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

11 Heathervale Close 03/10/06

11 Heathervale Close 21/12/05

11 Heathervale Close 06/12/04

11 Heathervale Close 04/05/04

11 Heathervale Close 05/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 12/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 11 Heathervale Close Hasland Chesterfield Derbyshire S41 0HY     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jill Wells     Date: 2 1 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: 11 Heathervale Close Hasland Chesterfield Derbyshire S41 0HY (01246)556647 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Enable Care & Home Support Limited Name of registered manager (if applicable) Vacant Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home The home is registered for 5 residents with a learning disability. Accommodation is provided on the ground floor and is accessible for wheelchair users. The home has three single and one double bedroom. The double room is used for single occupancy. There is a large lounge area and kitchen/dining room. A small utility room provides laundry facilities. Staff accommodation consists of a single bedroom/office. The home has a garden to the rear and side of the bungalow providing space for the service users to sit out. Car parking is provided at the front of the property. Residents at the home have a range of needs including mobility difficulties. They are supported to attend day services, and receive therapeutic treatments. The home has its own transport and additional staff are employed to support the mobility of residents and their participation in activities. The fees charged are £371.20 per week. Hairdressing, toiletries, the charge for meals at the day centre are not included in the fee. Care Homes for Adults (18-65 years) Page 4 of 30 care home 5 Over 65 0 5 Care Homes for Adults (18-65 years) Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for the service is two star. This means the people who use the service experience good quality outcomes. The inspection visit was unannounced and took place over 5 hours. There were 4 people living at the home on the day of the inspection. All residents, 3 staff, and the acting manager were spoken with during the visit. Two relatives were telephoned for their views. Some residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. We also looked at all the information that we have received, or asked for, since the last key inspection on the Care Homes for Adults (18-65 years) Page 6 of 30 3rd October 2006. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection report. Records were examined, including care records, staff records, maintenance, and health and safety records. A tour of the building was carried out. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Adults (18-65 years) Page 8 of 30 following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were given information about the service, so that they could be clear about what the service offers, although this information was not always in appropriate formats to help them understand the information. Evidence: The annual quality assurance assessment information completed by the service said that they provide each person with up-to-date information regarding the service provided via a service user guide. During the inspection visit the acting manager said that everybody had been given a service user guide, however these were kept in the staff room rather than with the individual. A copy the document was seen. The service user guide needed the telephone number of the Commission for Social Care Inspection so that people could contact us if they needed to. Other minor amendments were needed for example up to date information on the manager and staff. This guide was not provided in alternative formats. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: There had been no new people admitted to the home since the last inspection visit, however assessments were in place for people already residing at the home. All of the residents had been living at the home for a number of years. Care Homes for Adults (18-65 years) Page 12 of 30 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples health, personal and social care needs were well met in an individualised way and support was given to ensure that they had opportunities to make decisions about their own lives. Evidence: The annual quality assurance assessment information completed by the service said that service users are supported to make choices about all aspects of their daily routines and lives. During the inspection visit two peoples records were seen. They had very detailed plans of care and personal planning books in place which were pictorial to make them easier for people to understand. The plans were individualised and person centred and had all aspects of each persons health, social and personal care needs in place. Each person had a life history and, good things about me, things I like and dont like and, how to keep safe. Each person had recorded goals. One persons goal was to go Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: on more trips to the seaside and the zoo. Staff member spoken with said that they had been to the seaside twice as well as the zoo. Peoples plans evidenced that their independence was promoted for example by the use of equipment such as a rimmed dish and slip mat to help someone feed themselves. Risk assessments were in place for pressure areas and nutrition. There were also individualised risk assessments for example one person had a risk assessment in place for eating meals in bed which they sometimes liked to do. Each person had a care plan covering how staff should respect the individuals privacy and dignity. Some people were unable to tell staff their wishes. Their care plans around communication were in good detail. For example one said, ensure when speaking that you are at their height so you can see their facial expressions and they can see yours. Staff were observed following this guidance. People were encouraged to make decisions about their lives. For example one person came home and requested a bath before tea, then to have their meal on their own before other people ate as this person does not like to eat with other people. Staff supported this person with their request. A resident spoken with said, I can pretty much do as I like. Care Homes for Adults (18-65 years) Page 14 of 30 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The range of activities and standard of meals offered was good, which met the needs and wishes of people living at the home. Evidence: The annual quality assurance assessment information completed by the service said that all service users are supported to attend various day centres to suit their individual preferences and lifestyles. During the inspection visit three people were at a day centre, and later returned. They were spoken with and said that they enjoyed the various day centres that they attended. Two people attended a local evening club. Records showed and residents confirmed that birthdays and special events were celebrated. However staff were uncomfortable that when purchasing a Christmas present for each person they had to Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: use that persons own money. There was a minibus available and staff said that outings were more frequent in the good weather. Due to some sickness and maternity leave there were less times when there were additional staff to give flexibility for outings. One staff member explained that if there were only two staff on duty and they wanted to go out, they would compromise by taking people out on the bus for example to Carsington water and have a picnic on the bus rather than taking people out of the vehicle. A resident said that they did not mind whether they went out, they enjoyed being at home relaxing and listening to music. One person had additional staff time twice per week to take them out on a one-to-one basis. Individuals would sometimes go out with staff, for example shopping and banking. Two people had previously enjoyed a long weekend in London. They had requested this holiday again for 2008 but staff explained that due to the price this had not been possible. Instead people had been out on day trips to an aquatic centre and the coast. Two relatives were spoken with. Both confirmed that they were encouraged to visit. One person said I feel very welcome when I visit, I dont think (my relative) could get any better care. Another relative said, its a nice feeling when you walk in. There was a set menu. Staff said that residents helped to plan this menu.They said that individuals regularly asked for something different and these changes were recorded. People spoken with said the food was fine. Care Homes for Adults (18-65 years) Page 16 of 30 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal support was flexible, consistent and responsive to peoples changing needs so that people were provided with good quality care. Evidence: The annual quality assurance assessment information completed by the service said that all service users health care needs have been met. All staff have completed their medication assessment/training Staff spoken with confirmed that people were supported, taking fully into account their wishes and feelings. For example one person had very specific rituals that they wanted staff to follow and staff made sure that this happened. They explained that some residents liked to stay in bed when they were not at day centre. Staff would check with them when they wanted to be supported to get up. Anyone with non-verbal communication would be checked for signs that they were ready to get out of bed for example eyes open and smiling. Staff were able to describe how they ensured that personal support was provided in Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: private. Staff were also observed respecting peoples privacy. Peoples understanding of death and dying were recorded in their care plans. Staff said that everyone had a bath or shower daily. One person spoken with said, I love to have a bath, it stops my aching. There were detailed records of regular contact with GPs and other health professionals. Signatures of health professionals were obtained for treatment when there were issues of consent. Relevant technical aids and equipment were available, with guidance from relevant health professionals. Record showed that advice was sought when necessary. Peoples weight was being monitored and action taken if necessary. Each person had a personal handling risk assessment. Staff spoken with confirmed that these were accurate and up-to-date. The medication systems were checked. They were generally in good order. Medication administration records were clear and accurate. There was a system for receipt and return of medication. However there was not a record of medication carried forward when new medication has been received, making an audit trail difficult. The record of returning medication only had a signature of the staff member making the record. There was no signature of the person that the medication was returned to. Care Homes for Adults (18-65 years) Page 18 of 30 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are aware of the action to take if allegations of abuse or complaints are made and systems are in place to respond appropriately and ensure the ongoing protection of people. Evidence: The annual quality assurance assessment information completed by the service said that staff complete all necessary training and follow the policies and procedures. All concerns and complaints are taken seriously and acted upon. During the inspection visit the complaints leaflet was seen in individuals files. These did not have the telephone number of the Commission for Social Care Inspection in case anybody wished to contact us. There had been a serious safeguarding adult issue raised since the last inspection visit. The service had dealt with this appropriately, involving the police and Social Services and took the correct action in order to protect people. They had kept the Commission for Social Care Inspection informed throughout. Training records showed that staff had received training in safeguarding adults, although some refresher training was due. A staff member spoken with was very clear about what was meant by whistleblowing and staff responsibilities. Care Homes for Adults (18-65 years) Page 19 of 30 Care Homes for Adults (18-65 years) Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe, well-maintained and comfortable environment, which encourages independence. Evidence: The annual quality assurance assessment information completed by the service said that they provide a homely environment, personalised to each individuals needs and ensure that the required equipment is provided. During the inspection visit a tour of the premises took place. The home was clean and well maintained. Several people showed me their room. Each room was personalised with their own photographs and belongings. The rooms were suitable for wheelchair users. There were no locks on bedroom doors. A resident spoken with said that they had been asked if they wanted a lock but had said no. Staff felt no one would be able to manage a lock or key. There was a large, pleasant lounge area. New furniture had recently been purchased. There was a pleasant outside area that was paved with seating. There was a bathroom with specialist bathing facilities and a shower. There was also a Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: separate toilet. This toilet was badly marked and looked unsightly. The acting manager said that this was due to rods being used after several blockages and the marks would not come off. The home was fully accessible for wheelchair users providing level access and doorways with adequate width. Maintenance records showed that repairs were quickly done. The kitchen had recently been refurbished and they were now awaiting a new extractor fan. Some bedrooms had also been recently redecorated. A resident said, I like my bedroom, it is comfy. A relatives spoken with said, the environment is lovely, plenty of space and It doesnt feel like a care home. It is always very clean. There was a separate laundry area with a domestic washing machine and dryer. Staff spoken with were aware of the procedure for dealing with spillages and use of protective clothing. Care Homes for Adults (18-65 years) Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment practices and staff training programme were good and ensured that people were protected by competent, well-trained staff. There were sufficient numbers of staff to support the people who use the service. Evidence: The annual quality assurance assessment information completed by the service said that they ensure that all staff are appropriately trained and staffing levels meet the required needs of the service users. During the inspection visit the staff rotas were seen. These showed that there were two staff on duty at all times. At night there was one staff member awake and a second asleep, on call. Staff explained that due to sickness and maternity leave there had not been three staff on duty very often to give flexibility for outings (see lifestyle outcome). The service manager available for some of the inspection visit said that there was a budget available for additional staffing as required. Staff spoken with were clear about their roles and responsibilities. Most staff had worked at the home for a number of years and knew residents very well. It was evident through observations that staff had developed positive relationships with Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: service users that they support and were able to meet individuals needs. A relatives spoken with said, I can tell (my relative) is happy, she always wants to hug and kiss the staff. A resident spoken with said, staff are all nice, they are kind Information provided was that 50 of staff had achieved NVQ 2 Care. Staff were observed being very comfortable with service users, interested, motivated and good communicators. A staff member spoken with said, we work very well as a team and get on well. We do a good hand over and our records are good. The staff member described how they would work alongside any new staff to help them understand individuals needs. There were minutes of regular staff meetings. These were an opportunity to discuss roles, practices and any concerns. Two recruitment files were seen. These showed that safe recruitment practices were being followed. Training records were seen. Although staff had undertaken the relevant mandatory training including moving and handling, fire safety, safeguarding adults and first aid, some staffs records showed that they were not up to date with refresher training. Record showed that staff were receiving one-to-one supervision. Staff spoken with said that, having a number of different managers had been difficult but they generally felt well supported. Care Homes for Adults (18-65 years) Page 24 of 30 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are systems in place to ensure that the home is managed in the best interests of residents. Evidence: The annual quality assurance assessment information completed by the service said that the home is visited weekly by the service manager responsible for the service. There are regular staff meetings and staff supervision. Quality assurance systems are in place. At the time of the inspection visit the responsible individual was contacted due to concerns about the service not applying to register a manager with the Commission for Social Care Inspection (CSCI) for over two years. One manager left before registering, and there have been temporary managers since then. They have agreed to apply to register a temporary manager with CSCI. There was an acting manager in place as the temporary manager was off sick. The acting manager spoken with during the visit knew staff and residents well and was aware what her responsibilities were in her Care Homes for Adults (18-65 years) Page 25 of 30 Evidence: temporary role. There were completed questionnaires in peoples files. However in some cases this was not appropriate as the person had no verbal communication and the questionnaire was fully completed by a staff member. Minutes of residents meetings showed that people were consulted, however this was mainly concerning outings and activities. The Acting manager stated that policies and procedures were in place, however they were not checked on this occasion. Records required for the effective and efficient running of the business were maintained, up to date and accurate. Records were kept securely. Fire records were seen and these showed regular checks and fire drills. A sample of servicing records were seen and found to be in good order. The environmental health officer visited in 2007 and highlighted the need to monitor the fridge temperatures. A new fridge freezer was purchased as a result of this. The food probe was not working at the time. A new probe and safe probing system with records was now in place. Damaged cupboards and doors highlighted have all been replaced. There were records of the service manager visiting regularly and a monthly report of their unannounced visit. These report showed that they spent time talking to the staff and service users, checked the premises, records and recorded any action that was needed. The system for recording residents finances were checked. There was a safe system for obtaining money from peoples individual bank accounts and keeping small amounts at the home for them to use. Two staff members withdrew the money and two staff would check and sign the records. Balances were checked and found to be in good order. There were clear records of any accidents. One persons record showed an accident of a fall in the bathroom. The next day the moving and handling assessor visited to give advice to staff. This shows a quick response to any issues. Care Homes for Adults (18-65 years) Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 33 8 A manager must be 21/04/2009 appointed for the home and that person must apply to register with the CSCI. Previous timescale 01/02/07. This is an umet requirement from the previous inspection visit. A new timescale has been given as the provider is now making attempts to register a manager, however if this timescale is not met, enforcement action will be considered. This is to ensure that the provider meets the Care Home Regulations to have a registered manager in place. Care Homes for Adults (18-65 years) Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The service user guide should be made available to each person living at the home, in alternative formats if necessary and should include the telephone number of the Commission for Social Care Inspection. They should be regularly reviewed and amended. This is so that each person and their relative or advocate has accessible, up to date information about the service. There should be a record of medication carried forward when new medication is delivered to ensure that there is a clear audit trail. The record of medication returned should include the signature of the person that medication is being returned to. This is to ensure safe practice. The complaints leaflet should include the telephone number of the Commission for Social Care Inspection so that people can contact us if they wish to. Consideration should be given to replacing the toilet that is badly stained to ensure that people live in a pleasant environment. All staff should receive regular refresher training on all mandatory subjects to ensure that there knowledge is upPage 28 of 30 2 20 3 20 4 22 5 27 6 35 Care Homes for Adults (18-65 years) to-date. Care Homes for Adults (18-65 years) Page 29 of 30 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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